About Us

601 W Main Ave
Suite 400
Spokane, WA 99201
(509) 838-6541
Fax: (509) 458-4014

Rental Improvement Program Form

* = required field

All information is strictly confidential
 
*Owner:
   
Co-Owner: (if applicable)
   
*Phone Number:
   
*Mailing Address:
   
*Property Address:
   
*Choose One:
    Owner Occupied
Rental Property (see info needs below owner-occupied)
 
Owner Occupants Only
 
*Previous Year Total Income (All Sources) Taxable & Non-Taxable:
   
*Number of People in Household:
   
*Any Children Under 6 Who Live in Home?
    Yes
No
*Any Children Under 6 Visiting 6+ Hours per Week?
    Yes
No
*Any Pregnant Women Living in Home?
    Yes
No
Head of Household is?
    Male
Female
Date of Birth:
   
Year Built:
   
 
This section contains information for Equal Housing Opportunity Compliance. Providing this information is optional.
 
Applicant:
    I do not wish to furnish this information
Applicant Ethnicity:
   
Applicant Race:
   
Co-Applicant:
    I do not wish to furnish this information
Co-Applicant Ethnicity:
   
Co-Applicant Race:
   
Do you or any household member have a disability or require special accomodation?
    Yes
No
 
Rentals Only
 
Total Number of Units:
   
Number of Bedrooms:
   
1 Bedroom  » 
2 Bedroom  » 
3+ Bedroom  » 
Do You Rent to Low-Income Tenants?
    Yes
No
Comments:
   

Privacy Statement: The data submitted in this form will be used only for the benefit of the submitting party. This data will be retained by Kiemle & Hagood Company, and will not be given or sold to a third party for any other use.

Listing Type: For Sale
For Lease
Property Type: Office
Retail
Industrial
Multi-Family
Land
Street Number:
Street Name:
City:
Submarket:
Price/Rate: -
Square Feet: -
Acreage: -
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2065 W Riverstone Dr
Suite 101
Coeur d'Alene, ID 83814
(208) 770-2590
Fax: (208)770-2587

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